Changes in Histological Features of Nasal Polyps in a Korean Population over a 17‐year Period

Abstract

After comparison of histopathologic findings of nasal polyps from 1993 and 2011 at 1 academic medical center in Korea, the prevalence of eosinophilic nasal polyps, which are known to be rare among Asians, has significantly increased.

Role of interleukin 33 in chronic rhinosinusitis

“…By comparison, type 2 inflammatory responses characterised by interleukin (IL) 4, IL-5, IL-13 cytokine expression and eosinophilic inflammation are features of CRSwNP 1. This categorisation may, however, be oversimplified as recent studies show that this may be subject to racial and regional differences 2 3. While the majority of Caucasian patients sampled in the USA and Europe have a pronounced infiltration of eosinophils and expression of IL-5 in the NPs, patients with CRSwNP in East Asian countries including Japan, Korea and China, exhibit a mixed inflammatory profile.…”

“…It is undeniable that this may also reflect a lack of international consensus for defining tissue eosinophilia. While some groups define eosinophilia as an absolute number of eosinophils (five to eight) per random high powered field,3 5 6 others use a cut-off percentage of eosinophils (5–15%) for a number of high power fields counted in areas of greatest cellularity 7 8…”

Rethinking chronic rhinosinusitis phenotypes

“…However, what is particularly intriguing is that these presentations are not fixed but are evolving over time. 7,8 It has been argued that there have been distinct “allergy” epidemics: those for allergic rhinitis (1870–1920), asthma (1960–1990), and food allergy (1990–present) and perhaps a fourth epidemic if we include eosinophilic esophagitis. 9 Eosinophilic esophagitis seemingly did not exist or at least barely registered just a generation ago.…”

“…The actual prevalence of this particular phenotype might be similar in China and Belgium and, indeed, might be comparatively low. If true, like Thailand and Korea, 7,8 China will soon see an epidemic of eosinophilic CRS, which will become the most prominent presentation observed there as well.…”

Chronic rhinosinusitis management beyond intranasal steroids and saline solution irrigations

“…9 There has been a trend toward increasing eosinophilic nasal polyposis in Asian populations recently. 10,11 Local allergen-specific IgE and Th2 cytokines, such as IL-4, IL-5, and IL-13, have been identified in nasal polyp tissue, which indicates that atopy may further drive polyp formation. 12 Chronic inflammation is heterogeneous in CRS subtypes, including mucosal remodeling.…”